Delirium and Dementia Flashcards
Apraxia
Deficit in motor activites
Aphasia
Deficits in speech
Agnosia
Failure to recognize objects
DSM-5 criteria for major neurocognitive disorder (dementia)
- learning and memory
- Language
- Executive function
- Complex attention
- Perceptual-motor
- social cognition
For interpreting the MMSE with single cutoff, what does a score below 24 mean?
abnormal
above 24 is normal
Delirium diagnostic criteria
- reduced ability to focus
- reduced orientation
- short time period
- fluctuates
- due to physiologic consequence
What exam is more clinically useful and has a high specificity and sensitivity?
Confusion Assessment Method (CAM)
Confusion assessment method
- Acute mental status change that fluctuates
- Inattention
- Disorganized thinking
- Altered level of consciousness
need 1 + 2, and 3 or 4*
Which types of delirium is less recognized, less treated and has poorer prognosis?
Hypoactive delirium
If a patient has delirium due to anticholinergic drug overdose, what drug can be given to reverse this?
Physostigmine
What labs or inflammatory markers are associated with delirium?
- Elevated CRP
- Elevated Interleukin-1 beta
- Elevated Tumor necrosis factor (TNF)
Name some predisposing factors of delirium
- Male
- Hx of ETOH
- Sensory impairment
- Dementia
- Advanced age
Postoperative delirium is quite common (50% chance) after which proceedures?
- Cardiac surgery, AAA repair
- Hip fracture sx
When is the peak onset of delirium after surgery?
2nd postoperative day*
Which drugs should be avoided or reduced to decrease risk of delirium?
- Barbiturates
- Benzodiazepines
- H2 blockers
- Opioids (esp. meperidine)
- Antidepressants
- Antiparkinsonian agents
- alcohol
- anticonvulsants
